| National Provider Identifier [NPI]: | 1629040654 |
| Last Name Of The Provider | GUEVARA |
| First Name Of The Provider | JORGE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 425 E LOS EBANOS BLVD |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | BROWNSVILLE |
| Zip Code Of The Provider | 78520 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 277 |
| Number Of Services | 31737 |
| Number Of Medicare Beneficiaries | 1085 |
| Total Submitted Charge Amount | 5064746.13 |
| Total Medicare Allowed Amount | 1665042.78 |
| Total Medicare Payment Amount | 1295528.74 |
| Total Medicare Standardized Payment Amount | 1371572.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 2421 |
| Number Of Medicare Beneficiaries With Drug Services | 531 |
| Total Drug Submitted ChargeAmount | 45347.15 |
| Total Drug Medicare AllowedAmount | 15099.14 |
| Total Drug Medicare PaymentAmount | 13629.14 |
| Total Drug Medicare Standardized Payment Amount | 13629.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 262 |
| Number Of Medical Services | 29316 |
| Number Of Medicare Beneficiaries With Medical Services | 1085 |
| Total Medical Submitted Charge Amount | 5019398.98 |
| Total Medical Medicare Allowed Amount | 1649943.64 |
| Total Medical Medicare Payment Amount | 1281899.6 |
| Total Medical Medicare Standardized Payment Amount | 1357943.11 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 168 |
| Number Of Beneficiaries Age 65 to 74 | 471 |
| Number Of Beneficiaries Age 75 to 84 | 305 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 630 |
| Number Of Male Beneficiaries | 455 |
| Number Of Non Hispanic White Beneficiaries | 386 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 687 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 506 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 579 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 27 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.54 |